Healthcare expenditure necessitated within the Indian medical ecosystem may appear to be comparatively affordable from an expat’s perspective
Representative image. Credit: iStock Photo
Low-Income expat Indian workers who return home after retirement confront a host of economic, emotional and social challenges at the fag end of their lives. The situation is tough for the low-income, blue-collar workers who would have meagre savings after retirement, no coverage under government health schemes and are prone to suffer from age-related, major illnesses like heart attack, stroke and cancer, requiring huge amounts of treatment.
Many of them have to either forgo the treatment for themselves or their dependent spouses or face the harsh reality of debt by borrowing money from loan sharks. One of the practical ways to address this is to get proper health insurance coverage.
Healthcare expenditure necessitated within the Indian medical ecosystem may appear to be comparatively affordable from an expat’s perspective, but costs become prohibitive when the expat returns and has no source of income. Such a situation often drains the resources, especially for a large number of the migrant workforce employed in Gulf countries.
This inconspicuous and challenged segment deserves the concerned involvement of governmental policymakers as much as that of established insurance providers. While support systems that focus on the expat population can deliver some solutions, a pre-planned and enduring response mechanism needs to be urgently implemented to ensure that the low-income expat population who returns for good is allowed equitable and affordable access to health insurance coverage options.
Unfortunately, many of them who are in the low income group are not included in either the central or state government free health insurance schemes as they are not in the BPL list being NRIs. A constructive initiative that could effectively address this situational concern impacting an almost marginalised segment of the population is the proposal to involve the low-income expat population as beneficiaries in government-sponsored insurance schemes such as Ayushman Bharat. Such a move would benefit both the blue-collar employee expat and the segments experiencing social, political and economic exclusion. A gesture of acknowledgement extended to the expat community will accrue as an expression of relevant concern and serve to enhance the perception of Ayushman Bharat as a tool for assuring the dissemination of positive outcomes factored into inclusive welfare schemes. Lifelong health insurance coverage for the individual expat and spouse would amount to a significant indicator of inclusive interventions. An alternative proposal could involve insurance providers, in the private sector as well, designing participatory schemes; NRIs would be required to make remittances on a monthly or annual basis while they are working abroad. Considering that most start working at around 25 years of age and continue until retirement at 60, the premium can be conveniently remitted over a period of 20 to 30 years, in small amounts. Upon retirement and return to India, sufficient funds will have accumulated to enable lifetime health insurance coverage for the NRI and spouse. Indians living abroad number over 18 million; representing the world’s largest diaspora population. They remit billions of dollars every year to shore up the foreign exchange of the country. It will be a fitting gesture to provide them with the medical benefit for major conditions that are common in the latter part of a person’s life.
Kerala alone, with 30% of its income sourced from NRI remittances, saw an alarming influx of over 15 lakh returning migrants from six Gulf nations during the period between May 2020 and June, 2021, in the wake of the pandemic. Over 10 lakh reported job loss. The Non-Resident Keralites’ Affairs’ (NORKA) Department has endorsed these figures; implying the harsh reality of a financially destabilized demographic segment that demands immediate support.
It is true that illness and treatment costs pushes people into the BPL category from the middle-income group. Though health insurance schemes by the governments help avoid this, NRIs are presently not covered — it will be prudent to include low-income NRIs who fulfil the required criteria within the schemes to provide them with the benefit.
(The writer is Founder Chairman and MD of Aster DM Healthcare and Director, NORKA)